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On March 6, 2019, the U.S. Senate Committee on Finance gathered for a hearing to discuss cases of nursing home abuse and neglect that have plagued residents throughout the nation. Predominantly, the hearing shed light on the lack of preventive measures The Centers for Medicare and Medicaid Services have in place to protect residents from abuse and neglect. Chairman Chuck Grassley (R-IA) led the hearing along with Ranking Member Ron Wyden (D-OR).

During the hearing, several family members of abused and neglected residents shared testimonies about the harm and suffering their loved ones endured as a result of the grossly substandard care provided. One Minnesota woman recalled her mother’s rape by a nursing home caregiver, which left her mother crying and hitting her private parts for days, unable to communicate what happened. “We assured my mother that she would be safe: she would not suffer. I can never overcome the guilt of realizing that these promises were not kept: She was not safe, she was raped,” the daughter shared.

A woman from Iowa detailed her mother’s death while in a nursing home facility that had been given the highest rankings in quality measures by CMS. According to testimony, her mother was transferred to a hospital where she was found to be extremely dehydrated. The emergency room doctor stated the woman had not been given fluids in the last four to five days and said he planned on reporting the abuse. The woman passed away shortly after.

Tennessee Health Management, Inc. Pays $9.7 Million for Fraudulent Claims

In early February, U.S. Attorney for the Middle District of Tennessee, Don Cochran, announced Tennessee Health Management, Inc. would pay $9.7 million after allegedly submitting false claims to Tennessee’s Medicaid program, TennCare.

The management company owns 27 skilled nursing facilities in Tennessee, including three in Memphis and one in Cordova.

The opioid epidemic is not limited to any one age group, region or ethnicity. It is pervasive throughout the country and affects even the elderly in nursing homes and long-term care facilities.

According to The Centers for Medicare and Medicaid Services, 40 percent of all opioid overdose deaths involve a prescription opioid, and the drugs were responsible for more than 42,000 deaths in 2016 alone. As such, CMS has been striving to limit the number of prescribed opioids in the U.S. by encouraging doctors to prescribe such drugs only when the benefits outweigh the risks and by promoting the use of non-opioid pain treatments.

Over-Prescribing Opioids

All long-term care residents are at a risk for wandering. However, those with diseases that diminish cognitive abilities, such as dementia or Alzheimer’s, are more likely to wander or elope. In the most dangerous cases, elopement has led to serious injury and death.

While statistics vary on how frequently patients wander, one 2006 study found that at least one in five residents with dementia will wander at least once. The National Council of Certified Dementia Practitioners shared one case study in which a cognitively impaired woman wandered to the facility’s roof. No one noticed her absence for several hours. After a search was initiated, she was found suffering from severe hypothermia and passed away shortly after in the hospital.

This has significant implications for nursing home staff. Residents with dementia require extensive supervision, as patient safety is the nursing home’s main priority. This also encourages family members to assess a facility’s ability to safely care for their loved one before admitting them to a nursing home.

Kaiser Health News, along with an analysis conducted by Definitive Healthcare, released statistics in September 2018 detailing the severity of sepsis infections among nursing home residents. Approximately 25,000 nursing home patients are transferred to hospitals annually due to sepsis. Treatments for the infection are not cheap or quick — Medicare spends roughly $2 billion each year caring for sepsis sufferers.

In fact, sepsis was found as the leading cause of transfers from nursing homes to hospitals. Sadly, these cases lead to death “much more often” than other medical conditions, and the elderly pose an additional risk of getting the disease due to weaker immune systems.

Knowing the symptoms of sepsis and early detection are both key in preventing further, incurable damage to a loved one’s health.

Medicare has taken an aim to reward nursing homes based on their quality of care rather than quantity, and to penalize the homes that fall short. The recently implemented Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP) will redistribute funds to 14,959 skilled nursing facilities across the nation, based on how many nursing home residents are readmitted to a hospital within 30 days of discharge. While the SNF VBP financially encourages quality care, there is concern that nursing homes are now more reluctant to send ill patients to the hospital in order to dodge penalization.

According to CMS data analyzed by Modern Healthcare, approximately 73% of skilled nursing facilities were financially penalized in 2018, while a mere 27% received bonuses.

A nursing home may receive a deduction in funds as severe as 2%, and a bonus as high as 1.6% in Medicare Part A payments. Nearly 20% of skilled facilities received the maximum 2% pay cut, and only 3% of facilities received the full 1.6% bonus.

Nearly every major news outlet across the nation has been following the story of a 29-year-old Arizona nursing home resident that gave birth to a baby boy at the end of December while in a vegetative state. The disturbing facts of the case continue to shed light on the internal problems of nursing homes, the horrors of sexual assault and the prevalence of caretaker abuse and neglect.

Facts of The Case

On December 29, paramedics were dispatched to Hacienda HealthCare after receiving a 911 call from a nurse stating, “The baby’s turning blue!” Later in the phone call, the nurse told the dispatcher, “We had no idea she was pregnant.”

With the Me Too movement in full swing, more and more victims of sexual abuse are finding their voices and gaining the courage to speak out against assailants. The group that is perhaps the least empowered by the new campaign is the elderly. While sexual assault runs rampant throughout nursing homes and long-term care facilities, many times, the abuse goes unreported.

Sexual Abuse: A Frequent Evil in Nursing Homes

A February 2017 CNN report detailed just how serious the problem is. Since 2000, over 16,000 complaints of sexual abuse in nursing homes and assisted living facilities have been reported. While that number appears high, officials warn that the true figure of actual assaults is likely much higher. The reported 16,000 only accounts for cases that have been looked into and resolved by state long-term care ombudsmen; it does not account for other allegations.

Over the years, Jehl Law Group has become familiar with Poplar Oaks Rehabilitation and Healthcare Center by pursuing cases against the facility for claims of abuse and neglect. Unfortunately, the problems are far from isolated and undoubtedly numerous.

In 2017 alone, the nursing home, which has a one-star rating and is ranked “Much Below Average” on Nursing Home Compare, was cited 17 times by health inspectors, which is nearly three times the state average of five complaints per year.

Moreover, the home was forced to pay a fine of $11,000 in 2017 after regulators deemed the home did not correctly handle abuse allegations relating to a resident’s fractured ankle.

A recent audit conducted by the Tennessee Comptroller rated three of four state-run veterans’ homes below average in quality of resident care. In addition to poor scores, the study also cited the homes for not reporting veteran deaths accurately or timely and not running comprehensive background checks on employees.

Unlike the two VA nursing homes in Murfreesboro and Mountain Home run by the Department of Veterans Affairs, which were under a separate, national review in June after news sites uncovered hidden VA statistics, the care facilities reviewed in this audit are run by the state of Tennessee and are located in Clarksville, Humboldt, Knoxville and Murfreesboro.

Throughout the duration of the study, which lasted from Jan. 1, 2015 to June 30, 2018, Clarksville, which opened in January 2016, scored higher overall than Humboldt, Knoxville and Murfreesboro.